Dispensaries deleted? Well-regulated access to this medicine needed

Bob E. Blake

California voters legalized medical marijuana in 1996, but the drug remains illegal under federal law. The San Diego City Council has appointed an 11-member advisory task force to help establish regulatory guidelines.

My experience as a board-certified emergency physician in a busy hospital emergency department was long and varied. For 28 years, most of the people I cared for suffered from either acute or chronic pain.

Western medicine offers many helpful yet sometimes controversial medications for pain. Many drugs have negative side effects, which include the potential to cause organ damage, become addictive or be mind-altering or destructive to the overall quality of life.

The first known mention of cannabis (marijuana) is in a Chinese medical text of 2737 B.C. Research has shown that it was used as medicine throughout Asia and the Middle East. The United States National Academy of Sciences’ Institute of Medicine has concluded that many conditions can be treated with medical marijuana, including nausea, appetite loss, pain and anxiety. To maintain that there are no medicinal uses of marijuana simply flies in the face of scientific evidence.

With medical marijuana, the goal is generally to decrease the use of other drugs, either because of the presence of undesirable side effects or loss of efficacy. Patients are afforded an alternative to deal with their chronic medical issues.

Thirteen years ago, California voters supported medical marijuana when they passed Proposition 215, giving patients the right to possess, grow and use marijuana for medical purposes. In January, 2004, the California Legislature passed SB 420, which set guidelines for medicinal use and recognized the right of patients and primary caregivers to form collectives and cooperatives to cultivate and distribute medical marijuana.

State Attorney General Jerry Brown issued guidelines in August 2008 for the operation of nonprofit cooperatives and collectives, allowing them to exist for the purpose of providing medical marijuana to their members, but not as profit-making enterprises. Dispensaries, storefront boutiques that sell marijuana to anyone with a medical marijuana recommendation regardless of whether the person is a member of the collective, are afforded little, if any, protection under the California attorney general’s guidelines.

In February 2009, U.S. Attorney General Eric Holder announced that the federal government would no longer target medical marijuana patients; instead, he said that they would only target those who violated both state and federal laws. Over the next few months, more than 30 collectives, co-ops and dispensaries opened throughout San Diego County. Although many of these new businesses were operating in full compliance with state laws, many were not. Some of these new businesses were paying their employees under the table in cash and not providing them with W-2s. Others were selling marijuana to anyone with a physician’s recommendation rather than limiting sales to their members as the law specifies. Some had not filed their “not for profit status” paperwork with the state. Some of these new businesses had guns on the premises.

Clearly, this industry is in need of effective regulation that allows patients safe and convenient access to this medicine.

In early September, San Diego County District Attorney Bonnie Dumanis closed many of these businesses that were not complying with established guidelines and state law. Subsequently most have reopened.